7.3 Systemic therapy
In practice, several systemic treatment options are established for treating AE: Until approval of Dupilumab in 2017 and baricitinib in 2020, cyclosporine has been considered as first-line option over many years. Other drugs (e.g. azathioprine, methotrexate and mycophenolic acid) have been also used with good response, but off label and/or as second line therapy, in AE [113, 127]. The European Academy of Allergy and Clinical Immunology (EAACI) AE guideline group nicely summarized evidence on systemic treatments for AE identifying the need for trials comparing novel systemic treatments with conventional therapies [128].